Center hopes to speed health advances from lab to patients

J. Craig Venter discusses his career in genomics at UC San Diego’s Altman Clinical and Translational Research Institute. The talk was part of an afternoon of discussing how to translate scientific research into helping patients.

J. Craig Venter discusses his career in genomics at UC San Diego’s Altman Clinical and Translational Research Institute. The talk was part of an afternoon of discussing how to translate scientific research into helping patients.

As an aging population seeks improved health care, the costs of providing it keep rising. Meanwhile, promising research findings may remain stuck in the lab for years, helping no one.

A new field called translational science aims to provide relief by quickly moving new discoveries out of the lab so they can benefit patients. Last week at the University of California San Diego, young researchers heard real-life examples from their peers of how its done.

These include:

Developing a practical test for cystic fibrosis severity that can be run from a smartphone.

Training people of Pacific Islander ancestry in science to assist researchers in monitoring and improving health.

Developing an affordable treatment for an autoimmune condition called Kawasaki disease.

Reducing damage from radiation therapy for brain cancer.

Audience members also heard from a translational science veteran, J. Craig Venter, who has worked for decades to understand the human genome to improve disease treatments.

Venter described how his work has progressed from reading the genome to incorporating other health-related information to build as complete a picture as possible of a patient’s status. This work, performed at the Health Nucleus of Human Longevity Inc., includes assessing the kinds of microbes that live in and on people, the chemicals in their blood, and imaging their body.

J. Craig Venter describes his goal of going beyond a reactive evaluation of a patient’s present state to getting a good idea of how his or her health is likely to change.

J. Craig Venter describes his goal of going beyond a reactive evaluation of a patient’s present state to getting a good idea of how his or her health is likely to change.

The goal is to go beyond a reactive evaluation of a patient’s present state to getting a good idea of how his or her health is likely to change, Venter said. That would mean treatments can be given before disease even begins.

“We’re trying to go from where medicine is to pro-active and preventive,” Venter said. “We’re starting to get there, and we’re trying to change the notion of medicine of being a clinical science that’s supported by data, to data science supported by clinicians.”

Venter was the final speaker at the “Day of Translational Science” at UCSD’s Altman Clinical and Translational Research Institute. That annual event is meant to encourage new researchers, said Paul Mills, an event organizer and professor of family medicine and public health. Mills is also part of the leadership at the institute.

One of the institute’s goals is to get researchers from different disciplines to work together on common problems, Mills said. For example, a doctor might team up with an engineer to design a medical device — the doctor focused on medical needs while the engineer supplies prototypes.

At-home health monitoring

Speaker Drew Hall described how medical and engineering perspectives converged to make a smartphone sensor that cystic fibrosis patients can use at home to monitor their lung secretions. These provide insights into lung health or disease.

Hall, trained as an engineer, specializes in biosensors. He collaborated with Dr. Douglas Conrad, director of the UCSD Adult Cystic Fibrosis Clinic. Their goal was to leverage the technology already built in a smartphone, adding only what’s necessary to make it function as a biosensor.

Drew Hall describes how medical and engineering perspectives converged to make a smartphone sensor that cystic fibrosis patients can use at home.

Drew Hall describes how medical and engineering perspectives converged to make a smartphone sensor that cystic fibrosis patients can use at home.

For example, the biosensor is powered by the phone’s battery, taking only a minimal draw. Hall said having to charge yet another device would discourage patient use. The readout appears on the phone’s screen.

To make the biosensor usable on as wide a range of phones as possible, they made it plug into the audio jack, which is standard in nearly all phones. That required feats of engineering.

“The audio jack was not meant to power other devices, and it was not meant to send data back and forth,” Hall said. “It was meant for headphones. So there were a lot of tricks required in an engineering sense to overcome this disability.”

From the medical perspective, the biosensor tests for pH of lung secretions, which cystic fibrosis patients expel regularly. This allows for at-will monitoring for signs of infection, so patients don’t have to wait for a doctor’s visit. That means potentially dangerous changes can be detected in real time.

Speaker Christina Holub of Californa State University San Marcos described a different kind of translation, taking basic research education from universities into the community.

Holub is part of a team that works with those of Pacific Island ancestry, such as Samoans and Tongans, and native Hawaiians. At the top of their concerns: diabetes, obesity, smoking, alcohol use and cancer.

Christina Holub works with those of Pacific Island ancestry, such as Samoans and Tongans, and native Hawaiians

Christina Holub works with those of Pacific Island ancestry, such as Samoans and Tongans, and native Hawaiians

The team decided to encourage physical activity and modify dietary habits, in partnership with Rawmana Fitness, a Tongan-owned fitness studio in San Diego.

The main goal of the pilot study was to increase physical activity among participants over a 12-week period. Secondarily, body composition of participants was measured. Fortunately, many of the instruments needed to collect this information were already available at Rawmana Fitness.

The Rawmana Fitness team and other community members were trained in research principles, so they could collect information in a scientifically usable format. UCSD provides this training in what is called the BRIC program, said UCSD researcher Camille Nebeker, a colleague of Holub on the study. Information is available at https://bric.ucsd.edu.

Camille Nebeker describes UCSD's BRIC program to train people in the community to help researchers.

Camille Nebeker describes UCSD's BRIC program to train people in the community to help researchers.

The BRIC program was originally designed to help Hispanic women participate in research projects, and it begins with the basics.

“They were telling us as well as the PIs (principal investigators) and project managers that they don’t know what research is,” Nebeker said. “So we need to start at an introductory level of explaining the scientific method, talking about the different research designs, what is a variable, how is data collected, how is it stored.

“How, when you’re a community member and you’re the person responsible for implementing the study, and one of your neighbors is in the study, how do you protect their privacy? And how do you make sure that you’re respectful of your neighbors as people as well as participants?”

Breaking the cost barrier

Dr. Adriana Tremoulet, associate director of the Kawasaki Disease Research Program at UCSD, discussed work on developing a treatment that could be made more widely available to prevent heart aneurysms from the disease. It’s the most common cause of heart damage in children, far outstripping rheumatic fever, she said. It can also cause sudden death in undiagnosed young adults.

Dr. Adriana Tremoulet, associate director of the Kawasaki Disease Research Program at UCSD, discusses work on developing a treatment that could be made more widely available to prevent heart aneurysms from the disease.

Dr. Adriana Tremoulet, associate director of the Kawasaki Disease Research Program at UCSD, discusses work on developing a treatment that could be made more widely available to prevent heart aneurysms from the disease.

An existing treatment called intravenous immunoglobulin, or IVIG, is the standard of care for the disease, but how it works is poorly understood, Tremoulet said. It can also be too expensive in countries where the disease is most common, especially the Philippines and in India.

“One of the missions that we have as a center for this disease is to think broadly and for us to better understand the treatments that we give for this illness,” she said.

CAPTION

Genetic analysis conducted on one Neanderthal woman who lived 52,000 years ago was published Oct. 5 in a report in the journal Science. (October 6, 2017)

Genetic analysis conducted on one Neanderthal woman who lived 52,000 years ago was published Oct. 5 in a report in the journal Science. (October 6, 2017)

CAPTION

Genetic analysis conducted on one Neanderthal woman who lived 52,000 years ago was published Oct. 5 in a report in the journal Science. (October 6, 2017)

Genetic analysis conducted on one Neanderthal woman who lived 52,000 years ago was published Oct. 5 in a report in the journal Science. (October 6, 2017)

The Food and Drug Administration has launched a crackdown on clinics hawking stem cell treatments for a range of ailments. (September 1, 2017) (Sign up for our free video newsletter here http://bit.ly/2n6VKPR)

The Food and Drug Administration has launched a crackdown on clinics hawking stem cell treatments for a range of ailments. (September 1, 2017) (Sign up for our free video newsletter here http://bit.ly/2n6VKPR)

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Researchers used eggs from healthy females and the sperm of a man who carried a gene mutation that causes inherited hypertrophic cardiomyopathy. (Aug. 3, 2017) (Sign up for our free video newsletter here http://bit.ly/2n6VKPR)

Researchers used eggs from healthy females and the sperm of a man who carried a gene mutation that causes inherited hypertrophic cardiomyopathy. (Aug. 3, 2017) (Sign up for our free video newsletter here http://bit.ly/2n6VKPR)

Dr. Jona Hattangadi-Gluth discussed how she and colleagues adapted radiation therapy for brain cancer to reduce damage to cognition.

By using advanced brain imaging methods, Hattangadi-Gluth said her lab could detect subtle changes in brain microstructure that correlates with damage to healthy tissue.

They determined which regions of the brain’s white matter were most sensitive to radiation. They also examined how radiation affected the rate of thinning of the brain’s cortex as people age. Furthermore, they checked the rate of thinning in cortical areas responsible for memory and other higher-order functions.

Finally, they checked shrinkage in the hippocampus, which is critical for memory.

Using all this information, the researchers are testing modified “cognitive-sparing” radiation therapy that reduces damage to these sensitive areas as much as possible, while still treating the tumor.